Promus PREMIER Below The Knee Registry

Last updated: September 14, 2021
Sponsor: Sengkang General Hospital
Overall Status: Active - Recruiting

Phase

N/A

Condition

Claudication

Vascular Diseases

Circulation Disorders

Treatment

N/A

Clinical Study ID

NCT05054764
Promus PREMIER BTK
  • Ages > 21
  • All Genders

Study Summary

The Promus Premier below-the-knee (BTK) drug-eluting stent (DES) is specifically designed to improve BTK vessel patency rates using a platinum-chromium alloy based stent that elutes the anti-restenotic drug everolimus to inhibit neo-intimal hyperplasia. Although DES stents are considered standard of care for certain BTK lesions, there is a paucity of data on the use of DES in the contemporary BTK chronic limb threatening ischemia (CLTI) population, especially in Singapore. The aim of the Promus PREMIER BTK registry is to collect one year data of the Boston Scientific Promus PREMIER BTK DES in BTK lesions in CLTI patients.

Eligibility Criteria

Inclusion

Inclusion Criteria: Clinical inclusion criteria

  1. Subject is 21 years or older and has signed and dated the informed consent document (ICD)
  2. Subject is willing and able to comply with the study procedures, and follow-upschedule
  3. Subject has chronic, symptomatic related lower limb ischemia, determined by Rutherfordcategories 4 to 6 in the target limb, with wound(s) confined to toes/forefoot
  4. Subject is a male or non-pregnant female. If female or child-bearing potential, and ifsexually active must be using, or agree to use, a medically acceptable method of birthcontrol as confirmed by the investigator Intraoperative inclusion criteria
  5. Stenotic, restenotic or occlusive target lesion(s) located in the tibioperoneal trunk,anterior tibial, posterior tibial and/or peroneal artery(ies).
  6. Target lesion(s) must be at least 4cm above the ankle joint
  7. A single target lesion per vessel, in up to 2 vessels, in a single limb
  8. Degree of stenosis ≥ 70% by visual angiographic assessment
  9. RVD is between 2.5 - 3.75mm
  10. Total target lesion length (or series of lesion segments) to be treated is ≤ 140 mm (Note: Lesion segment(s) must be fully covered with up to two DES BTK stents)
  11. Target vessel(s) reconstitute(s) at or above the stenting limit zone (4cm above theankle joint)
  12. Target lesion(s) is in an area that may be stented without blocking access to patentmain branches
  13. Treatment of all above the knee inflow lesion(s) is successful prior to treatment ofthe target lesion
  14. Guidewire has successfully crossed the target lesion(s)

Exclusion

Exclusion Criteria: Clinical exclusion criteria

  1. Life expectancy ≤ 1year
  2. Stroke ≤ 90 days prior to the procedure date
  3. Prior or planned major amputation in the target limb
  4. Previous surgery in the target vessel(s) (including prior ipsilateral crural bypass)
  5. Previously implanted stent in the target vessel(s)
  6. Failed PTA of target lesion/vessel ≤ 60 days prior to the procedure date
  7. Heel gangrene
  8. Subject has a platelet count ≤ 50 or ≥ 600 X 103/µL ≤ 30 days prior to the proceduredate
  9. NYHA class IV heart failure
  10. Subject has symptomatic coronary artery disease (i.e., unstable angina)
  11. History of myocardial infarction or thrombolysis ≤ 90 days prior to the procedure date
  12. Non-atherosclerotic disease resulting in occlusion (e.g., embolism, Buerger's disease,vasculitis)
  13. Subject is currently taking Canagliflozin
  14. Body Mass Index (BMI) <18
  15. Active septicaemia or bacteraemia
  16. Coagulation disorder, including hypercoagulability
  17. Contraindication to anticoagulation or antiplatelet therapy
  18. Known allergies to stent or stent components
  19. Known allergy to contrast media that cannot be adequately pre-medicated prior to theinterventional procedure
  20. Known hypersensitivity to heparin
  21. Subject is on a high dose of steroids or is on immunosuppressive therapy
  22. Subject is currently participating, or plans to participate in, anotherinvestigational study that may confound the results of this study Intraoperative exclusion criteria
  23. Angiographic evidence of intra-arterial acute/subacute thrombus or presence ofatheroembolism
  24. Treatment required in > 2 target vessels (Note: a target lesion originating in onevessel and extending into another vessel is considered 1 target vessel)
  25. Treatment requires the use of alternate therapy in the target vessel(s)/lesion(s), (e.g., atherectomy, cutting balloon, re-entry devices, laser, radiation therapy)
  26. Aneurysm is present in the target vessel(s)
  27. Extremely calcified lesions
  28. Failure to obtain <30% residual stenosis in a pre-existing lesion

Study Design

Total Participants: 30
Study Start date:
August 16, 2021
Estimated Completion Date:
August 31, 2023

Study Description

Peripheral arterial disease (PAD) is an atherosclerotic condition in which chronic inflammation of the arteries may result in CLTI and ultimately limb loss without treatment. This problem is likely to worsen with the increasing global prevalence of diabetes. The arterial blockage for diabetic CLTI patients occur predominantly in the BTK arteries which are challenging to treat effectively due to the high incidence of elastic recoil and high stenosis rates after plain old balloon angioplasty (POBA) of these often calcified lesions. The additional use of BTK drug-coated balloons (DCBs) have also not demonstrated any significant improvements compared to POBA. The Boston Scientific Promus Premier BTK DES is a next generation DES specifically designed to improve BTK vessel patency using a platinum-chromium alloy-based stent that elutes everolimus. It is made with the most radiopaque biocompatible alloy available with superior axial strength, exceptional conformability, maximum fracture resistance, higher radial strength and less recoil compared to cobalt alloy stent. It also has the highest labelled post-dilatation limits compared to other stents, providing clinicians with more flexibility during procedures. Subjects will be followed up at 1 month, 3 month, 6 month and 12 month post-intervention to assess primary and secondary efficacy and safety.

Connect with a study center

  • Sengkang General Hospital

    Singapore, 544886
    Singapore

    Active - Recruiting

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